Most Ridiculous Med Order

psu_213, BSN, RN · Jul 17, 2015

"pt. had large BM on day shift"

Well, we have all had those days where we were s*** on. :cool:

psu_213, BSN, RN · Jul 17, 2015

Hi Christy1019,
Yes, I've seen it a few times myself, and the idea is to use it sparingly, because quite rightly, syncope and hypotension is a risk!
And lol at the women mixing up the creams. A bit of an ewww too at that!

I worked with a nurse who, as a new nurse, taped over a pt's orifice applying NTG ointment to a pt's hemorrhoids. :wideyed:

Christy1019, ASN, RN · Jul 18, 2015

I worked with a nurse who, as a new nurse, taped over a pt's orifice applying NTG ointment to a pt's hemorrhoids.

I've never heard of NTG used for that either. Why would you apply a vasodilator to an already swollen, engorged vessel ? Wouldn't you want something to constrict the vessels?

psu_213, BSN, RN · Jul 18, 2015

I've never heard of NTG used for that either. Why would you apply a vasodilator to an already swollen, engorged vessel ? Wouldn't you want something to constrict the vessels?

That was my question too...I'm not sure the rationale behind it.

Jensmom7, BSN, RN · Jul 18, 2015

"Potassium 40 mEq IV push" for a K+ of 3.9. They were going to push it through a 22 g. on the hand of a sweet little octagenerian. I had to have the Pharmacist put a stop to that one because neither the brand new intern (out of Med School two weeks) or the brand new GN (hadn't even taken her boards yet) believed me when I tried to explain what a bad idea it was -- and why.

Was the sweet little octogenarian on Death Row perhaps? Yikes.

Jasel, BSN, RN · Jul 19, 2015

Recently had a young 20s heroin OD, given 2mg of Narcan in the field, AOx3 upon arrival to ED. Vitals stable, tachy in the low 100s. He ordered a full work up. Even blood cultures. No medical hx, took no medications, the only abnormal lab result was a potassium of 3.2 (which he ordered nothing for). I gave another 1 mg of Narcan and he made me put her on a Narcan drip -_- He admitted this patient to the ICU. The entire thing was bizarre but fortunately won't be working with that doctor again.

psu_213, BSN, RN · Jul 19, 2015

IV morphine (ended up with 2 doses) for hemorrhoid pain. Was that really necessary??? :grumpy:

AJPV · Jul 19, 2015

Fentanyl drip ordered to run at 900 mL/hr on a med-surg unit (dying patient). At a concentration of 5 mcg/mL, that equates to 4,500 mcg/hr. I told the doc I wasn't comfortable euthanizing the patient.

Ruby Vee, BSN · Jul 20, 2015

Fentanyl drip ordered to run at 900 mL/hr on a med-surg unit (dying patient). At a concentration of 5 mcg/mL, that equates to 4,500 mcg/hr. I told the doc I wasn't comfortable euthanizing the patient.

Good for you!

OTOH, we have a young SICU patient on a Fentanyl drip at 3600 mcg/hr AND Propofol at 60 mcg/kg/min AND Versed at 24 mg/hour. Not breathing spontaneously, but hypertensive, tachycardic and oxygenating and ventilating with proper support. Wild! Docs won't order paralytics.

Christy1019, ASN, RN · Jul 20, 2015

Good for you!
OTOH, we have a young SICU patient on a Fentanyl drip at 3600 mcg/hr AND Propofol at 60 mcg/kg/min AND Versed at 24 mg/hour. Not breathing spontaneously, but hypertensive, tachycardic and oxygenating and ventilating with proper support. Wild! Docs won't order paralytics.

Whoa!! May I ask why they are in the SICU? That's an insane amount of medication!

mercurysmom · Jul 20, 2015

This is from a LTC facility: "tonic water 4oz PO PRN per pt request to burp or fart." This was for a LOL who had a bowel obsession and was on at least 4 scheduled stool softener and laxatives and had a fit if she went 12 hours without a "movement." With all those bowel meds, I'd be afraid to fart!

Jensmom7, BSN, RN · Jul 21, 2015

This is from a LTC facility: "tonic water 4oz PO PRN per pt request to burp or fart." This was for a LOL who had a bowel obsession and was on at least 4 scheduled stool softener and laxatives and had a fit if she went 12 hours without a "movement." With all those bowel meds, I'd be afraid to fart!

I'd be afraid to stand behind her...